ISSN 2398-2985      

Stomatitis

Jreptile
Contributor(s):

Mark Naguib

Yvette Rowntree

Synonym(s): Mouth rot, Infectious stomatitis, Ulcerative stomatitis, Oral inflammation

Podcast:


Introduction

  • Cause: bacterial, viral and fungal infections, usually secondary to suboptimal husbandry.
  • Signs: purulent discharge, caseous plaques, facial swellings, anorexia, lethargy.
  • Diagnosis: clinical examination, radiography, cytology and culture.
  • Treatment: topical and systemic antibiotics and antifungals, surgery, analgesia and assisted feeding alogside husbandry changes.
  • Prognosis: variable depending on extent and chronicity of disease and whether underlying osteomyelitis is present.

Pathogenesis

Etiology

  • Compromised oral mucosa due to:
    • Immunosuppresion.
    • Underlying viral infection, eg Herpesvirus.
    • Putrefaction of food during hibernation.
    • Oral, rostral and dental trauma.
    • Damage to dentition.
    • Damage caused by metabolic bone disease Metabolic bone disease/SNHP.
    • Hypovitaminosis A Hypovitaminosis A and squamous metaplasia.
    • Pentastomid infection (wild-caught animals).
  • Secondary opportunistic infection:
    • Pseudomonas , Aeromonas, E. coli, Bacteriodes, Clostridia, Fusobacterium, Proteus, Devriesia, Mycobacteria, Mycoplasma.
    • Herpes and rana viruses (chelonians).
    • Candida, Aspergillus and other opportunist fungal infections.
  • Progression to osteomyelitis Osteomyelitis and respiratory disease Lower respiratory tract disease.

Predisposing factors

General

  • Suboptimal temperatures, humidity and ventilation.
  • Poor calcium and vitamin D3 supplementation leading to metabolic bone disease/ SNHP.
  • Hypovitaminosis A Hypovitaminosis A.
  • Suboptimal UVB provision Chelonia husbandry Lizard husbandry Snake husbandry.
  • Rostral trauma.
  • Tooth damage and periodontal disease Periodontal disease often secondary to inappropriate diet.
  • Latent herpes virus Herpes virus infection, ranavirus and mycoplasma infection in chelonia.
  • Poorly implemented hibernation Hibernation / brumation, including lack of prehibernation management, lack of monitoring, excessive length  and no temperature control.
  • Putrefaction of food during hibernation related to poor prehibernation management.
  • Gout Gout which is often secondary to renal disease Renal disease.

Specific

  • Lively or nervous species kept in unsuitable enclosures may be at risk of rostral trauma, eg Chinese water dragons.

Pathophysiology

  • Compromise of oral mucosa.
  • Invasion by bacteria, fungi and viruses.
  • Severe inflammatory reaction.
  • Progression to osteomyelitis.
  • Spread to eyes and respiratory tract.
  • Inability to eat and starvation.
  • Septicemia may follow

Timecourse

  • Often chronic but not noticed by owners.

Epidemiology

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Hedley J (2016) Anatomy and disorders of the oral cavity of reptiles and amphibians. Vet Clin North Am Exotic Anim Pract 19 (3), 689–706 PubMed.
  • Johnson A J et al (2008) Ranavirus infection of free-ranging and captive box turtles and tortoises in the united states. J Wildl Dis 44 (4), 851–863 PubMed.
  • Soares J F et al (2004) Prevalence of Mycoplasma agassizii and chelonian herpesvirus in tortoises (Testudo sp.) in the United Kingdom. J Zoo Wildl Med 35 (1), 25–33 PubMed.
  • Mans C & Braun J (2014) Update on common nutritional disorders of captive reptiles. Vet Clin North Am Exotic Anim Pract 17 (3), 369–395 PubMed.

Other sources of information

  • Klaphake E, Gibbons P M, Sladky K K & Carpenter J W (2018) Reptiles. In: Exotic Animal Formulary. 5th edn. Ed: Carpenter J W & Marion C J. Saunders Elsevier, USA. pp 81-166.
  • Mehler S & Bennett R A (2006) Upper Alimentary Tract Disease. In: Reptile Medicine and Surgery. Ed: Mader D R. Saunders Elsevier, USA. pp 924–930.
  • McArthur S (2004) Problem-Solving Approach to Common Diseases. In: Medicine and Surgery of Tortoises and Turtles. Eds: McArthur S, Wilkinson R, Meyer J. Wiley-Blackwell, UK.
  • McArthur S, McLellan L & Brown S (2004) Gastrointestinal System. In: BSAVA Manual of Reptiles. Eds: Girling S & Raiti P. BSAVA, UK. pp. 210–229.

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